I'll take a stab at the benefits of psychodynamic therapy
I'm torn about whether to post because I don't want to add to divisiveness in the conversation. On the other hand, I am a therapist (and a psychoanalytically trained one at that!) and I'd like to contribute what I believe. Not every analyst would agree with my view. For those who are familiar with these terms, my orientation is contemporary relational analysis although I have a background in emperical research and I'm probably more of an integrationist than other therapists.
It's easy when articulating what you believe to say what you do not. That makes sense, but it tends to exaggerate small differences between positions, which feeds the considerable animosity between more psychoanalytic and more behavioral camps. I believe that cognitive behavioral therapies and psychoanalytic therapies are more similar in practice than their practitioners often want to admit. (I say that from reading books and journal articles about CBT and from talking to colleagues who practice it – not from personal experience as a CBT client or therapist.) Both types of therapeutic styles are based on the belief that talking to a therapist one trusts and respects can create changes in well-being and behavior over time. That may sound like a minor similarity but research on therapy effectiveness shows that for most problems, different therapeutic styles are equally effective. That is, across most diagnostic categories, talk therapy works for about 80% of those who try it. Further, the most important impact on the outcome of therapy is the working alliance, the sense of a close, productive relationship between the client and therapist.
That research has been somewhat humbling for therapists of all stripes. How do you defend the way you've chosen to practice if no one school has a leg up on the others? Instead of ignoring the obvious point that many different styles of therapy can achieve a useful working alliance, the camps quibble about the research. The CBT people say that the research shows that some problems lend themselves to CBT interventions. The analysts say that therapeutic outcomes aren't captured well with quantitative measures of symptom reduction. I think they're both right. Moreover, I believe that the most important factor in choosing a therapist is not that person's orientation but your sense that the person is intelligent, attentive, respectful, and makes you feel as safe as possible in discussing your problems.
That said, when I decided to become a therapist I was more compelled by contemporary analytic therapy because I feel the training is more comprehensive and nuanced than many other varieties. I felt that analytic work provided a better base from which to learn other techniques.
Contemporary analysis has come a long way from Freudian technique and even theory, although they share the basic principle that there is a large part of our mental life that influences our behavior but is outside of our conscious awareness. An analyst listens for unconscious themes in the client's relationships or beliefs about the self and the way the world operates. The process of therapy involves investigating those beliefs and ways of relating. This is a collaborative process in which client and analyst discuss the nuances of the beliefs and how they arose. Although there is an assumption that the patterns of relating arose largely out of early relationships, one of the elegant aspects of analysis is that the work can shift back and forth from what the client remembers about these early patterns to his or her current relationships. Indeed, another hallmark of analytic therapy is the focus on a client's transference to the therapist. We “transfer” our desires, expectations, fears, and assumptions that were formed in our childhood relationships to the complex, adult relationships we have today. The therapist and client examine the client's experience of this transferential relationship to understand how the client relates to other people and how s/he might do so differently. Of course, the therapist has his/her own transferences, and tries to stay aware of the “countertransference” that s/he experiences for the client, both as a way to learn what the client evokes in others and to understand what the therapist might be bringing from his/her own past to the work.
We've all had different experiences of love, joy, sexual desire, loss, rage, jealousy, and sometimes even devastating trauma. Analytic therapy honors the unique ways that people experience these events, and gives the client the opportunity to understand his or her way of seeing the world so that s/he can make conscious decisions about whether to continue with a formerly unconscious way of being. This is what I find most compelling about analytic therapy: the privileging of the client's uniqueness and his or her own responsibility for making choices that are appropriate for him or her.
Whew! If you've read this far, thanks for reading!
If the moderaters think it's too far off the purpose of the board, they can close the thread. That's their decision and I'll certainly respect that, but let's allow them to make the call.